Key result
In a cohort of 49 patients with atrial septal defects, the aortic rim was the most commonly absent rim (63.3%), highlighting the morphological challenges for transcatheter device closure.
Why the study?
Morphological variations of atrial septal defect rims are frequent and impact transcatheter closure feasibility, requiring detailed assessment by TEE.
Observational (n=49)
No
A significant proportion of patients undergoing TEE for ASD device closure have absent rims, particularly the aortic rim, which can make transcatheter closure more challenging.
Background and Aims: Transcatheter Atrial septal defects (ASD) closure has become the better alternative to surgical closure. Morphological variations of ASD are frequent. We aim to study the rims of ASD in Transesophageal echocardiogram (TEE).Methods: It was a retrospective single center audit done at Shahid Gangalal National Heart Centre, Kathmandu, Nepal. TEE clips of all the patients who underwent TEE evaluation for ASD device closure in our centre between June to August 2017 were studied.Results: During the study period 49 patients underwent TEE to evaluate the rims of ASD for device closure. Atrioventricular rim was good in all patients but it was floppy in one patient. In four chamber view, posterior rim was good in 21(42.8%) patients, floppy in 19 (38.7%) patients and absent in nine (18.5%) patients. Aortic rim was good in 15 (30.6%) patients, floppy in three (6.1%) patients and absent in 31(63.3%) patients. Posterior rim in short axis was good in 17 (34.6%) patients, floppy in 24 (48.9%) patients while it was absent in eight (16.3%) patients. Inferior venacava rim was good in 16 (32.6%) patients, floppy in 23 (46.9%) patients, while absent in ten (20.4%) patients. Superior venacava rim was good in 45 (91.8%) patients, floppy in one (2.1%) patient and absent in three (6.1%) patients. Two (4.1%) patients had two ASDs.Conclusion: Most of the ASD patients have absent rims which makes the procedure more demanding and challenging.
No takes yet. Share an insight, caveat, or question.
Adhikari et al. (2017) conducted an observational in Atrial septal defect (n=49). Transesophageal echocardiogram assessment of ASD rims was evaluated on Morphological variations and adequacy of atrial septal defect rims. In a cohort of 49 patients with atrial septal defects, the aortic rim was the most commonly absent rim (63.3%), highlighting the morphological challenges for transcatheter device closure.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: